呼吸机相关性肺炎的危险因素与病原菌分析

发布时间：2018-03-17 09:11

本文选题：呼吸机相关性肺炎　切入点：危险因素　出处：《中华医院感染学杂志》2014年24期 　论文类型：期刊论文

【摘要】：目的探讨呼吸机相关性肺炎感染的危险因素及病原菌分布,为早期预防和控制呼吸机相关性肺炎提供科学依据。方法选取2012年2月-2014年2月医院ICU行机械通气的172例患者资料进行回顾性分析,对其发生呼吸机相关性肺炎的临床特点、危险因素及病原菌的分布进行研究,所有数据采用SPSS11.0进行统计分析。结果 172例机械通气患者发生呼吸机相关性肺炎78例,发生率为45.35%;78例呼吸机相关性肺炎患者送检痰标本,共检出病原菌105株,其中革兰阴性菌62株占59.05%,革兰阳性菌27株占25.71%,真菌16株占15.24%;呼吸机相关性肺炎的危险因素与年龄、基础疾病、机械通气时间、是否存在意识障碍、气管切开、侵入性操作、抗菌药物的应用、住院时间有关。结论 ICU患者并发呼吸机相关性肺炎的危险因素较多,严格呼吸机的相关使用指征,针对危险因素给予相应的护理措施,严格执行无菌化管理,预防反流和误吸的发生,合理使用抗菌药物,可有效降低呼吸机相关性肺炎的发生率。
[Abstract]:Objective to investigate the risk factors and pathogenic bacteria distribution of ventilator-associated pneumonia infection. Methods the data of 172 patients with mechanical ventilation in ICU from February 2012 to February 2014 were analyzed retrospectively and the clinical characteristics of ventilator-associated pneumonia were analyzed. The risk factors and the distribution of pathogenic bacteria were studied. All the data were statistically analyzed by SPSS11.0. Results there were 78 cases of ventilator-associated pneumonia in 172 patients with mechanical ventilation, and the incidence was 45.35%, and the sputum samples of 78 cases of ventilator-associated pneumonia were examined. A total of 105 strains of pathogenic bacteria were detected, of which 62 were Gram-negative bacteria (59.05), 27 Gram-positive bacteria (25.71), and 16 fungi (15.24cm). The risk factors and age of ventilator-associated pneumonia, basic diseases, mechanical ventilation time, whether there is any disturbance of consciousness, were found. Tracheotomy, invasive operation, use of antimicrobial agents, length of stay are related to the length of stay. Conclusion there are many risk factors in patients with ICU complicated with ventilator-associated pneumonia. According to the risk factors, nursing measures, strict aseptic management, prevention of reflux and aspiration, rational use of antimicrobial agents can effectively reduce the incidence of ventilator-associated pneumonia.
【作者单位】：台州市中西医结合医院ICU;台州市第一人民医院ICU;浙江大学附属第一医院呼吸内科;
【基金】：浙江省医药卫生科技基金资助项目(2011QDF353)
【分类号】：R563.1

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